Previous research suggests that Home Health Care can both prevent institutionalization of the elderly, reduce their consumption of acute hospital services, and increase the quality of their life. This application seeks funding to evaluate the effectiveness of a newly established comprehensive, community-based and hospital-linked Home Care Program (the Five Hospital Homebound Elderly Program in Chicago) which differs significantly from previously studied programs and would appear to be a prototype for programs to be covered under expanded Medicare benefits. The evaluation will consist of (1) a study of the impact of the Program's services on client functioning and (2) a study of the differential utilization of the Program's services by its clientele. The evaluation of impact entails a quasi-experimental design utilizing a non-equivalent control group with pre- and post-test measures. A multidimensional functional assessment instrument (Duke/OARS) will be used to measure both control and experimental groups at time of entry to service and nine months later on the functional dimensions of social resources, economic resources, mental health, physical health and ability to perform activities of daily living. Statistical analysis (including multiple regression and/or analysis of variance) of mean pre- and post-test scores on these functional dimensions and of mean cumulative impairment scores (sum of the scores on the five functional dimensions) will be performed as well as analysis of other outcome measures such as rates of hospitalization, lengths of hospital stay, rates of nursing home admissions and survival to evaluate the effectiveness of the Program's services. In addition, data on client utilization of Program services will be collected and analyzed to determine the level of utilization associated with any observed impact.